| NPI | 1053418632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AK 123552) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT RN20818) |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP30007390) | |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2019-01-29 |